The physics of photodynamic therapy

Tailoring photobiomodulation to enhance tissue regeneration

Photobiomodulation (PBM), the use of biocompatible tissue-penetrating light to interact with intracellular chromophores to modulate the fates of cells and tissues, has emerged as a promising non-invasive approach to enhancing tissue regeneration. Unlike photodynamic or photothermal therapies that require the use of photothermal agents or photosensitizers, PBM treatment does not need external agents. With its non-harmful nature, PBM has demonstrated efficacy in enhancing molecular secretions and cellular functions relevant to tissue regeneration. The utilization of low-level light from various sources in PBM targets cytochrome c oxidase, leading to increased synthesis of adenosine triphosphate, induction of growth factor secretion, activation of signaling pathways, and promotion of direct or indirect gene expression. When integrated with stem cell populations, bioactive molecules or nanoparticles, or biomaterial scaffolds, PBM proves effective in significantly improving tissue regeneration. This review consolidates findings from in vitro, in vivo, and human clinical outcomes of both PBM alone and PBM-combined therapies in tissue regeneration applications. It encompasses the background of PBM invention, optimization of PBM parameters (such as wavelength, irradiation, and exposure time), and understanding of the mechanisms for PBM to enhance tissue regeneration. The comprehensive exploration concludes with insights into future directions and perspectives for the tissue regeneration applications of PBM.

Photodynamic therapy in oral cancer: a review of clinical studies

A significant mortality rate is associated with oral cancer, particularly in cases of late-stage diagnosis. Since the last decades, oral cancer survival rates have only gradually improved despite advances in treatment. This poor success rate is mainly due to the development of secondary tumors, local recurrence, and regional failure. Invasive treatments frequently have a negative impact on the aesthetic and functional outcomes of survivors. Novel approaches are thus needed to manage this deadly disease in light of these statistics. In photodynamic therapy (PDT), a light-sensitive medication called a photosensitizer is given first, followed by exposure to light of the proper wavelength that matches the absorbance band of the photosensitizer. The tissue oxygen-induced cytotoxic free radicals kill tumor cells directly, harm the microvascular structure, and cause inflammatory reactions at the targeted sites. In the case of early lesions, PDT can be used as a stand-alone therapy, and in the case of advanced lesions, it can be used as adjuvant therapy. The current review article discussed the uses of PDT in oral cancer therapy based on recent advances in this field.

Monitoring Protein Denaturation of Egg White Using Passive Microwave Radiometry (MWR)

Passive microwave radiometry (MWR) is a measurement technique based on the detection of passive radiation in the microwave spectrum of different objects. When in equilibrium, this radiation is known to be proportional to the thermodynamic temperature of an emitting body. We hypothesize that living systems feature other mechanisms of emission that are based on protein unfolding and water rotational transitions. To understand the nature of these emissions, microwave radiometry was used in several in vitro experiments. In our study, we performed pilot measurements of microwave emissions from egg whites during denaturation induced by ethanol. Egg whites comprise 10% proteins, such as albumins, mucoproteins, and globulins. We observed a novel phenomenon: microwave emissions changed without a corresponding change in the water’s thermodynamic temperature. We also found striking differences between microwave emissions and thermodynamic temperature kinetics. Therefore, we hypothesize that these two processes are unrelated, contrary to what was thought before. It is known that some pathologies such as stroke or brain trauma feature increased microwave emissions. We hypothesize that this phenomenon originates from protein denaturation and is not related to the thermodynamic temperature. As such, our findings could explain the reason for the increase in microwave emissions after trauma and post mortem for the first time. These findings could be used for the development of novel diagnostics methods. The MWR method is inexpensive and does not require fluorescent or radioactive labels. It can be used in different areas of basic and applied pharmaceutical research, including in kinetics studies in biomedicine.

HPV-induced condylomata acuminata treated by Photodynamic Therapy in comparison with trichloroacetic acid: A randomized clinical trial

OBJECTIVES

This is a randomized controlled clinical trial comparing Photodynamic Therapy (PDT) and the application of trichloracetic acid (TAA) in the treatment of HPV condyloma in the perianal and vulva regions. Design, Randomised controlled, open label, trial. They were allocated to each treatment following randomization by a computer program.

SETTING

Women Health Ambulatory in São Carlos city, São Paulo State in the Brazil.

PARTICIPANTS

36 patients evaluated. 31 patients fulfilled the study requirements.

INTERVENTION

Photodynamic Therapy (PDT) versus trichloracetic acid (TAA). The PDT protocol used the prodrug methyl aminolevulinate incubated for 3 hours and irradiation at 630 nm (100 J/cm²). In the treatment using TAA, warts received a small amount of acid using a cotton swab. Both treatments were repeated weekly until the lesions disappeared completely or until 10 sessions were completed.

MAIN OUTCOME MEASURE

Clinical analysis. Follow-up between 12 and 30 months after the complete treatment.

RESULTS

A total of 16 patients were treated with PDT and 15 patients with TAA. A complete response rate of 60% for TAA and 63% for PDT, with a recurrence rate of 33% for TAA and 0% for PDT.

CONCLUSION

PDT appears not only to treat lesions due to physical destruction of condyloma and subclinical lesions, but also to modulate the immune system and/or also to decrease the local viral load, suggesting a lower recurrence compared to the TAA group.

Mesoporous Silica-Coated Upconverting Nanorods for Singlet Oxygen Generation: Synthesis and Performance

Photodynamic therapy (PDT) has been reported as a possible pathway for the treatment of tumors. The exploration for promising PDT systems thus attracts continuous research efforts. This work focused on an ordered core–shell structure encapsulated by mesoporous SiO₂ with the upconverting emission property following a surfactant-assisted sol–gel technique. The mesoporous silica shell possessed a high surface area-to-volume ratio and uniform distribution in pore size, favoring photosensitizer (rose bengal) loading. Simultaneously, upconverting nanocrystals were synthesized and used as the core. After modification via hydrophobic silica, the hydrophobic upconverting nanocrystals became hydrophilic ones. Under near-infrared (NIR) light irradiation, the nanomaterials exhibited strong green upconverting luminescence so that rose bengal could be excited to produce singlet oxygen. The photodynamic therapy (PDT) feature was evaluated using a ¹O₂ fluorescent indicator. It was found that this core–shell structure generates ¹O₂ efficiently. The novelty of this core–shell structure was the combination of upconverting nanocrystals with a mesoporous SiO₂ shell so that photosensitizer rose bengal could be effectively adsorbed in the SiO₂ shell and then excited by the upconverting core.

Role of Photo-Biomodulation Therapy in Facial Rejuvenation and Facial Plastic Surgery

Photo-biomodulation (PBM) also known as low-level laser therapy is a rising technology with multiple potential uses in medicine and recently in the cosmetic field for the treatment of skin conditions and skin rejuvenation. Due to its wound healing and anti-inflammatory properties, there is an increase in popularity in its use as adjunctive treatment before and after surgical procedures in the face and neck.

Review of in vivo optical molecular imaging and sensing from x-ray excitation

SIGNIFICANCE

Deep-tissue penetration by x-rays to induce optical responses of specific molecular reporters is a new way to sense and image features of tissue function in vivo. Advances in this field are emerging, as biocompatible probes are invented along with innovations in how to optimally utilize x-ray sources.

AIM

A comprehensive review is provided of the many tools and techniques developed for x-ray-induced optical molecular sensing, covering topics ranging from foundations of x-ray fluorescence imaging and x-ray tomography to the adaptation of these methods for sensing and imaging in vivo.

APPROACH

The ways in which x-rays can interact with molecules and lead to their optical luminescence are reviewed, including temporal methods based on gated acquisition and multipoint scanning for improved lateral or axial resolution.

RESULTS

While some known probes can generate light upon x-ray scintillation, there has been an emergent recognition that excitation of molecular probes by x-ray-induced Cherenkov light is also possible. Emission of Cherenkov radiation requires a threshold energy of x-rays in the high kV or MV range, but has the advantage of being able to excite a broad range of optical molecular probes. In comparison, most scintillating agents are more readily activated by lower keV x-ray energies but are composed of crystalline inorganic constituents, although some organic biocompatible agents have been designed as well. Methods to create high-resolution structured x-ray-optical images are now available, based upon unique scanning approaches and/or a priori knowledge of the scanned x-ray beam geometry. Further improvements in spatial resolution can be achieved by careful system design and algorithm optimization. Current applications of these hybrid x-ray-optical approaches include imaging of tissue oxygenation and pH as well as of certain fluorescent proteins.

CONCLUSIONS

Discovery of x-ray-excited reporters combined with optimized x-ray scan sequences can improve imaging resolution and sensitivity.

Surgical Guidance for Removal of Cholesteatoma Using a Multispectral 3D-Endoscope

We develop a stereo-multispectral endoscopic prototype in which a filter-wheel is used for surgical guidance to remove cholesteatoma tissue in the middle ear. Cholesteatoma is a destructive proliferating tissue. The only treatment for this disease is surgery. Removal is a very demanding task, even for experienced surgeons. It is very difficult to distinguish between bone and cholesteatoma. In addition, it can even reoccur if not all tissue particles of the cholesteatoma are removed, which leads to undesirable follow-up operations. Therefore, we propose an image-based method that combines multispectral tissue classification and 3D reconstruction to identify all parts of the removed tissue and determine their metric dimensions intraoperatively. The designed multispectral filter-wheel 3D-endoscope prototype can switch between narrow-band spectral and broad-band white illumination, which is technically evaluated in terms of optical system properties. Further, it is tested and evaluated on three patients. The wavelengths 400 nm and 420 nm are identified as most suitable for the differentiation task. The stereoscopic image acquisition allows accurate 3D surface reconstruction of the enhanced image information. The first results are promising, as the cholesteatoma can be easily highlighted, correctly identified, and visualized as a true-to-scale 3D model showing the patient-specific anatomy.

Light Sources and Dosimetry Techniques for Photodynamic Therapy

Effective treatment delivery in photodynamic therapy (PDT) requires coordination of the light source, the photosensitizer, and the delivery device appropriate to the target tissue. Lasers, light-emitting diodes (LEDs), and lamps are the main types of light sources utilized for PDT applications. The choice of light source depends on the target location, photosensitizer used, and light dose to be delivered. Geometry of minimally accessible areas also plays a role in deciding light applicator type. Typically, optical fiber-based devices are used to deliver the treatment light close to the target. The optical properties of tissue also affect the distribution of the treatment light. Treatment light undergoes scattering and absorption in tissue. Most tissue will scatter light, but highly pigmented areas will absorb light, especially at short wavelengths. This review will summarize the basic physics of light sources, and describe methods for determining the dose delivered to the patient.

Long-Circulating Prostate-Specific Membrane Antigen-Targeted NIR Phototheranostic Agent

Targeted photodynamic therapy (PDT) combined with image-guided surgical resection is a promising strategy for precision cancer treatment. Prostate-specific membrane antigen (PSMA) is an attractive target due to its pronounced overexpression in a variety of tumors, most notably in prostate cancer. Recently, we reported a pyropheophorbide-based PSMA-targeted agent, which exhibited long plasma circulation time and effective tumor accumulation. To further advance PSMA-targeted photodynamic therapy by harvesting tissue-penetrating properties of the NIR light, we developed a bacteriochlorophyll-based PSMA-targeted photosensitizer (BPP), consisting of three building blocks: (1) a PSMA-affinity ligand, (2) a peptide linker to prolong plasma circulation time and (3) a bacteriochlorophyll photosensitizer for NIR fluorescence imaging and photodynamic therapy (Qy absorption maximum at 750 nm). BPP exhibited excellent PSMA-targeting selectivity in both subcutaneous and orthotopic mouse models. The nine D-peptide linker in BPP structure prolonged its plasma circulation time (12.65 h). Favorable pharmacokinetic properties combined with excellent targeting selectivity enabled effective BPP tumor accumulation, which led to effective PDT in a subcutaneous prostate adenocarcinoma mouse model. Overall, bright NIR fluorescence of BPP enables effective image guidance for surgical resection, while the combination of its targeting capabilities and PDT activity allows for potent and precise image-guided photodynamic treatment of PSMA-expressing tumors.

A New handheld singlet oxygen detection system (SODS) and NIR light source based phantom environment for photodynamic therapy applications

Photodynamic therapy (PDT) is an emerging treatment modality in various areas such as cancer treatment and disinfection. The photosensitizer and oxygen have crucial roles for effective PDT treatment. The quantitative evaluation of singlet oxygen, which is a gold standard for monitoring effective treatment, remains as an important problem for PDT. However, low quantum yield and low life span of the singlet oxygen make the system expensive, unnecessarily large and unadaptable for clinical usage. In our study, a new mobile singlet oxygen detection system (SODS) was designed to detect singlet oxygen illumination during PDT and a new singlet oxygen phantom environment was constituted to test the designed SODS system. The singlet oxygen phantom environment composed of fast switching led driver & microcontroller and led light source (1200-1300 nm radiation). The elements of the singlet oxygen detection system are optic filter and collimation, avalanche photodiode transimpedance amplifier, differential amplifier and a signal processing block. According to the performance evaluation of the system on the phantom environment, the presented SODS can measure the illuminations at 1270 nm wavelength between 10 ns and 15 µs timespans. The results showed that the proposed system might be a good candidate for clinical PDT applications.

Radioluminescence in biomedicine: physics, applications, and models

The electromagnetic spectrum contains different frequency bands useful for medical imaging and therapy. Short wavelengths (ionizing radiation) are commonly used for radiological and radionuclide imaging and for cancer radiation therapy. Intermediate wavelengths (optical radiation) are useful for more localized imaging and for photodynamic therapy (PDT). Finally, longer wavelengths are the basis for magnetic resonance imaging and for hyperthermia treatments. Recently, there has been a surge of interest for new biomedical methods that synergize optical and ionizing radiation by exploiting the ability of ionizing radiation to stimulate optical emissions. These physical phenomena, together known as radioluminescence, are being used for applications as diverse as radionuclide imaging, radiation therapy monitoring, phototherapy, and nanoparticle-based molecular imaging. This review provides a comprehensive treatment of the physics of radioluminescence and includes simple analytical models to estimate the luminescence yield of scintillators and nanoscintillators, Cherenkov radiation, air fluorescence, and biologically endogenous radioluminescence. Examples of methods that use radioluminescence for diagnostic or therapeutic applications are reviewed and analyzed in light of these quantitative physical models of radioluminescence.

Photodynamic and photobiological effects of light-emitting diode (LED) therapy in dermatological disease: an update

Benefit deriving from the use of light is known since ancient time, but, only in the last decades of twentieth century, we witnessed the rapid expansion of knowledge and techniques. Light-emitted diode (LED)-based devices represent the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The present work reviews the current knowledge about LED-based therapeutic approaches in different skin and hair disorders. LED therapy represents the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The use of LED in the treatment of such conditions has now entered common practice among dermatologists. Additional controlled studies are still needed to corroborate the efficacy of such kind of treatment.

Electrophoretic Deposited Stable Chitosan@MoS2 Coating with Rapid In Situ Bacteria-Killing Ability under Dual-Light Irradiation

Developing in situ disinfection methods in vivo to avoid drug-resistant bacteria and tissue toxicity is an urgent need. Here, the photodynamic and photothermal properties of the chitosan-assisted MoS₂ (CS@MoS₂ ) hybrid coating are simultaneously inspired to endow metallic Ti implants with excellent surface self-antibacterial capabilities. This coating, irradiated by only 660 nm visible light (VL) for 10 min, exhibits an antibacterial efficacy of 91.58% and 92.52% against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), respectively. The corresponding value is 64.67% and 57.44%, respectively, after irradiation by a single 808 nm near infrared light for the same amount of time. However, the combined irradiation using both lights can significantly enhance the efficiency up to 99.84% and 99.65% against E. coli and S. aureus, respectively, which can be ascribed to the synergistic effects of photodynamic and photothermal actions. The former produces single oxygen species under 660 nm VL while the latter induces a rise in temperature of implants, which can inhibit the growth of both E. coli and S. aureus. The introduction of CS can also promote the biocompatibility of implants, which provides a facile, rapid, and safe in situ bacteria-killing method in vivo without needing a second surgery.

Plasmono-magnetic material for precise photothermal heating

Noble metal nanoparticles have been extensively studied as photo-sensitive agents for photothermal cancer therapy. Precise control over the size and shape of the nanoparticles allowed strong optical absorption and efficient heat generation necessary for destroying a tumor to be achieved. However, one of the fundamental challenges of application of the nanoparticles towards photothermal cancer therapy is low specificity in the targeting tumor tissue in comparison with the healthy tissue and the resulting unfavorable biodistribution of the nanoparticles. Additional levels of control over particle distribution can be achieved by making the particles magnetic and using external magnets to control their accumulation in a tumor. Since the direct synthesis of particles with a magnetic core and a metallic shell limits the options for design and fine-tuning of plasmonic properties, the alternative approaches to the design of such materials have to be investigated. Here we propose and demonstrate a new design of a hybrid plasmono-magnetic material for photothermal heating created by grafting Au nanocages onto a surface of magnetic micro-beads. Next, we confirm its dual functionality in in vitro studies and show that individual hybrid particles can be magnetically controlled with a precision of a few micrometers and precisely destroy individual cells using plasmonic heating.

We demonstrated a new hybrid plasmono-magnetic material for photothermal heating created by grafting Au nanocages onto a surface of magnetic micro-beads.

WITHDRAWN: Treatment of cancer by low intensity laser radiation therapy

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Editorial Board of Progress in Biophysics and Molecular Biology retracts this paper due to an accusation of plagiarism. After careful review, the Editorial Board believes sufficient evidence exists to support this accusation. The author does not dispute the fact that: (i) The paper "Treatment of cancer by low intensity laser radiation therapy" -- which was submitted to Progress in Biophysics and Molecular Biology (PBMB) in June 2017, and which was accepted for publication (http://doi.org/10.1016/j.pbiomolbio.2017.11.002)-- has been published previously in near-identical form. (ii) The previous publication appeared in the June 2017 issue of Cancer Biology (http://doi.org/10.7537/marscbj070217.11). (iii) The author explains that this is an administrative mix-up with another paper published in Cancer Biology in September 2017 (http://doi.org/10.7537/marscbj070317.03). The article duplicates significant paragraphs from the other published article. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.

Interstitial PDT using diffuser fiber-investigation in phantom and in vivo models

Photodynamic therapy (PDT) has been used for local treatment of several types of tumors. Light penetration of biological tissue is one limiting factor in PDT, decreasing the success rates of the treatment of invasive and solid tumors. In those cases, a possible solution is to use interstitial PDT, in which both diffuser optical fibers are inserted into the tumor. The uniformity of the diffuser emission plays a crucial role in planning the delivery of the appropriate light fluence and in ensuring treatment success. In this study, we characterized a diffuser optical fiber concerning its homogeneity. We showed that the diffuser emission can be inhomogeneous and that the necrosis generated by interstitial PDT using such a diffuser for illumination is asymmetrical in volume as a result. This observation has relevant consequences in achieving success in PDT and phototherapies in general, as the delivered light fluence depends on adequate previous knowledge of the irradiation profile.

Using electron microscopy to calculate optical properties of biological samples

The microscopic structural origins of optical properties in biological media are still not fully understood. Better understanding these origins can serve to improve the utility of existing techniques and facilitate the discovery of other novel techniques. We propose a novel analysis technique using electron microscopy (EM) to calculate optical properties of specific biological structures. This method is demonstrated with images of human epithelial colon cell nuclei. The spectrum of anisotropy factor g, the phase function and the shape factor D of the nuclei are calculated. The results show strong agreement with an independent study. This method provides a new way to extract the true phase function of biological samples and provides an independent validation for optical property measurement techniques.

Beyond the Barriers of Light Penetration: Strategies, Perspectives and Possibilities for Photodynamic Therapy

Photodynamic therapy (PDT) is a photochemistry based treatment modality that involves the generation of cytotoxic species through the interactions of a photosensitizer molecule with light irradiation of an appropriate wavelength. PDT is an approved therapeutic modality for several cancers globally and in several cases has proved to be effective where traditional treatments have failed. The key parameters that determine PDT efficacy are 1. the photosensitizer (nature of the molecules, selectivity, and macroscopic and microscopic localization etc.), 2. light application (wavelength, fluence, fluence rate, irradiation regimes etc.) and 3. the microenvironment (vascularity, hypoxic regions, stromal tissue density, molecular heterogeneity etc.). Over the years, several groups aimed to monitor and manipulate the components of these critical parameters to improve the effectiveness of PDT treatments. However, PDT is still misconstrued to be a surface treatment primarily due to the limited depths of light penetration. In this review, we present the recent advances, strategies and perspectives in PDT approaches, particularly in cancer treatment, that focus on increasing the 'damage zone' beyond the reach of light in the body. This is enabled by a spectrum of approaches that range from innovative photosensitizer excitation strategies, increased specificity of phototoxicity, and biomodulatory approaches that amplify the biotherapeutic effects induced by photodynamic action. Along with the increasing depth of understanding of the underlying physical, chemical and physiological mechanisms, it is anticipated that with the convergence of these strategies, the clinical utility of PDT will be expanded to a powerful modality in the armamentarium for the management of cancer.

Photodynamic Therapy for Non-Melanoma Skin Cancers

Non-melanoma skin cancer (NMSC) is traditionally treated with surgical excision. Nonsurgical methods such as cryotherapy and topical chemotherapeutics, amongst other treatments, are other options. Actinic keratosis (AKs) are considered precancerous lesions that eventually may progress to squamous cell carcinoma (SCC). Photodynamic therapy (PDT) offers an effective treatment for AKs, and is also effective for superficial basal cell carcinoma (BCC). Nodular BCC and Bowen's disease (SCC in situ) have shown acceptable response rates with PDT, although recurrence rates are higher for these two NMSC subtypes. Methylaminolevulinate (MAL) PDT is a more effective treatment option than 5-aminolevulinic acid (ALA) PDT for nodular BCC. Several studies have shown that PDT results in superior cosmetic outcomes compared to surgical treatment. PDT is overall well-tolerated, with pain being the most common side effect.

Revisiting photodynamic therapy dosimetry: reductionist & surrogate approaches to facilitate clinical success

Photodynamic therapy (PDT) can be a highly complex treatment, with many parameters influencing treatment efficacy. The extent to which dosimetry is used to monitor and standardize treatment delivery varies widely, ranging from measurement of a single surrogate marker to comprehensive approaches that aim to measure or estimate as many relevant parameters as possible. Today, most clinical PDT treatments are still administered with little more than application of a prescribed drug dose and timed light delivery, and thus the role of patient-specific dosimetry has not reached widespread clinical adoption. This disconnect is at least partly due to the inherent conflict between the need to measure and understand multiple parameters in vivo in order to optimize treatment, and the need for expedience in the clinic and in the regulatory and commercialization process. Thus, a methodical approach to selecting primary dosimetry metrics is required at each stage of translation of a treatment procedure, moving from complex measurements to understand PDT mechanisms in pre-clinical and early phase I trials, towards the identification and application of essential dose-limiting and/or surrogate measurements in phase II/III trials. If successful, identifying the essential and/or reliable surrogate dosimetry measurements should help facilitate increased adoption of clinical PDT. In this paper, examples of essential dosimetry points and surrogate dosimetry tools that may be implemented in phase II/III trials are discussed. For example, the treatment efficacy as limited by light penetration in interstitial PDT may be predicted by the amount of contrast uptake in CT, and so this could be utilized as a surrogate dosimetry measurement to prescribe light doses based upon pre-treatment contrast. Success of clinical ALA-based skin lesion treatment is predicted almost uniquely by the explicit or implicit measurements of photosensitizer and photobleaching, yet the individualization of treatment based upon each patients measured bleaching needs to be attempted. In the case of ALA, lack of PpIX is more likely an indicator that alternative PpIX production methods must be implemented. Parsimonious dosimetry, using surrogate measurements that are clinically acceptable, might strategically help to advance PDT in a medical world that is increasingly cost and time sensitive. Careful attention to methodologies that can identify and advance the most critical dosimetric measurements, either direct or surrogate, are needed to ensure successful incorporation of PDT into niche clinical procedures.

Evaluation of Antimicrobial Photodynamic Therapy against Streptococcus mutans Biofilm in situ

AIM

This study investigated the effect of antimicrobial photo-dynamic therapy (aPDT) over Streptococcus mutans biofilm.

MATERIALS AND METHODS

Eighteen (n = 18) patients were selected and one palatine device with dental blocks was used. The biofilm was treated by curcumin and Photogem® with a LED and the effect was analyzed by CFU/ml.

RESULTS

Although, statistical analysis showed significant reductions for aPDT mainly with Photogem® (p = 0.02), these were low.

CONCLUSION

The results suggest a low antimicrobial effect of aPDT over S. mutans biofilm. Some parameters used need to be improved.

CLINICAL SIGNIFICANCE

This technique can be a promising in Dentistry.

Perfusion CT estimates photosensitizer uptake and biodistribution in a rabbit orthotopic pancreatic cancer model: a pilot study

RATIONALE AND OBJECTIVES

It was hypothesized that perfusion computed tomography (CT), blood flow (BF), blood volume (BV), and vascular permeability surface area (PS) product parameters would be predictive of therapeutic anticancer agent uptake in pancreatic cancer, facilitating image-guided interpretation of human treatments. The hypothesis was tested in an orthotopic rabbit model of pancreatic cancer, by establishing the model, imaging with endoscopic ultrasound (EUS) and contrast CT, and spatially comparing the perfusion maps to the ex vivo uptake values of the injected photosensitizer, verteporfin.

MATERIALS AND METHODS

Nine New Zealand white rabbits underwent direct pancreas implantation of VX2 tumors, and CT perfusion or EUS was performed 10 days postimplantation. Verteporfin was injected during CT imaging, and the tissue was removed 1 hour postinjection for frozen tissue fluorescence scanning. Region-of-interest comparisons of CT data with ex vivo fluorescence and histopathologic staining were performed.

RESULTS

Dynamic contrast-enhanced CT showed enhanced BF, BV, and PS in the tumor rim and decreased BF, BV, and PS in the tumor core. Significant correlations were found between ex vivo verteporfin concentration and each of BF, BV, and PS.

CONCLUSIONS

The efficacy of verteporfin delivery in tumors is estimated by perfusion CT, providing a noninvasive method of mapping photosensitizer dose.

Toxicity of chlorophyllin in different wavelengths of visible light against Fasciola gigantica larvae

Toxicity of chlorophyllin against redia and cercaria larvae of Fasciola gigantica was studied under irradiation of visible light. Highest and lowest toxicity of chlorophyllin against both larvae was noted under red (redia - 8 h LC₅₀ 7.88 mg/10 mL and cercaria - 11.99 mg/10 mL) and green (redia - 8 h LC₅₀ 32.12 mg/10 mL and cercaria - 8 h LC₅₀ 43.80 mg/10 mL) light irradiation respectively. The highest toxicity of chlorophyllin under red light irradiation against redia (8h LC₅₀ 7.88 mg/10 mL)/cercaria (8h LC₅₀ 11.99 mg/10 mL) was followed by white (8 h LC₅₀ redia - 20.48 mg/10 mL, 8 h LC₅₀ cercaria - 18.0 3mg/10 mL), blue (8 h LC₅₀ redia - 33.10 mg/10 mL/ 8 h LC₅₀ cercaria - 19.98 mg/10 mL) and yellow (8 h LC₅₀ redia - 23.87 mg/10 mL/ 8 h LC₅₀ cercaria - 23.48 mg/10 mL). Chlorophyllin treatment in darkness (control I) and without treatment of chlorophyllin, while all other conditions were same as treatment group (control II) caused no mortality of redia/cercaria larva. Chlorophyllin might be a promising new safe strategy to replace synthetic larvicide in fasciolosis control programme.

CT contrast predicts pancreatic cancer treatment response to verteporfin-based photodynamic therapy

The goal of this study was to determine dominant factors affecting treatment response in pancreatic cancer photodynamic therapy (PDT), based on clinically available information in the VERTPAC-01 trial. This trial investigated the safety and efficacy of verteporfin PDT in 15 patients with locally advanced pancreatic adenocarcinoma. CT scans before and after contrast enhancement from the 15 patients in the VERTPAC-01 trial were used to determine venous-phase blood contrast enhancement and this was correlated with necrotic volume determined from post-treatment CT scans, along with estimation of optical absorption in the pancreas for use in light modeling of the PDT treatment. Energy threshold contours yielded estimates for necrotic volume based on this light modeling. Both contrast-derived venous blood content and necrotic volume from light modeling yielded strong correlations with observed necrotic volume (R² = 0.85 and 0.91, respectively). These correlations were much stronger than those obtained by correlating energy delivered versus necrotic volume in the VERTPAC-01 study and in retrospective analysis from a prior clinical study. This demonstrates that contrast CT can provide key surrogate dosimetry information to assess treatment response. It also implies that light attenuation is likely the dominant factor in the VERTPAC treatment response, as opposed to other factors such as drug distribution. This study is the first to show that contrast CT provides needed surrogate dosimetry information to predict treatment response in a manner which uses standard-of-care clinical images, rather than invasive dosimetry methods.

Comparison of efficiency of photodynamic diagnostics with topical use of the 3% and 15% aminolevulinic acid in the detection of vulvar lesions

The essence of the photodynamic diagnostic method is interaction between light and chemical compounds that form in reaction to light. In order to obtain fluorescence, tissue has to be exposed to energy in the form of light with the wavelength corresponding to the bandwidth of the photosensitizer absorption. The photodynamic method allows for the detection of even small lesions. This method facilitates the process of detecting vulvar cancer, especially in its early stages when it can develop on the foundation of overgrown epithelium. At that point the vulvoscopic image is difficult to interpret, in particular when multifocal growth occurs.

OBJECTIVES

The objective of the study was evaluating the efficiency of the photodynamic method PDD (photodynamic diagnosis) in the detection of vulvar lesions when two concentrations of the photosensitizer were used (3%- and 15%-aminolevulinic acid), as well as evaluating the efficiency of this method when compared to the efficiency of vulvoscopy, against the result of histological examination.

METHODS

Two concentrations of the 5-ALA cream (aminolevulinic acid) - 3% and 15% - were used in the PDD testing. The study group was divided into two subgroups A and B. In subgroup A the 15% eucerine-based cream was used. In subgroup B the 3% ALA gel with and addition of 2% DSMO was used. The photosensitizer was applied to the vulva 4-6h before the examination. In order to obtain fluorescence, energy in the form of light whose wavelength was approximately 405 nm, and whose source was a SLED diode, was transmitted to vulvar tissue. The positive result of the exam was obtaining tissue fluorescence. All patients underwent vulvoscopy and a histological examination of tissue samples was performed in all cases. The efficiency of the photodynamic testing in subgroups A and B was compared with the efficiency of vulvoscopy, against the result of histological examination. Sensitivity, specificity, as well as positive and negative predictive values of the PDD examination and vulvoscopy in both subgroups, were evaluated.

RESULTS

When the 15% ALA was used in detecting vulvar lesions, the photodynamic diagnostics was characterized by sensitivity of 100%, specificity of 92%, positive predictive value of 80%, negative predictive value of 100%, and correlation with the histopathological examination of 93.9%. When the 3% ALA was used, we observed: sensitivity of 100%, specificity of 91.4%, positive predictive value of 78.5%, negative predictive value of 100%, and correlation with the histopathological examination of 93.4%. Differences in the two subgroups were not statistically significant.

CONCLUSIONS

High correlation was observed between the accuracy of the photodynamic method of examining vulvar lesions and the accuracy of the histological examination, especially in cases of precancerous lesions and vulvar cancer. The photodynamic examination, when the 3%-ALA/2%DSMO is used, is characterized by a greater sensitivity, comparable specificity, as well as, comparable positive and negative prognostic values, in comparison to the vulvoscopic examination. The photodynamic method, when used with other diagnostic methods, facilitates performing the needle aspiration biopsy and allows for a greater precision of histological diagnoses. The pathological fluorescence obtained during the PDD examination gives information about the spread and multifocality of vulvar lesions, which can facilitate making presurgical decisions concerning the extensiveness of surgery. The photodynamic method, when the 3% ALA/2% DSMO is applied topically, is of comparable efficiency as the 15% ALA, in the detection of vulvar lesions. High safety of the photodynamic method was shown, both in terms of the topical application of the aminolevulinic acid and the subsequent use of light.

Crossed and linked histories of tetrapyrrolic macrocycles and their use for engineering pores within sol-gel matrices

The crossed and linked histories of tetrapyrrolic macrocycles, interwoven with new research discoveries, suggest that Nature has found in these structures a way to ensure the continuity of life. For diverse applications porphyrins or phthalocyanines must be trapped inside solid networks, but due to their nature, these compounds cannot be introduced by thermal diffusion; the sol-gel method makes possible this insertion through a soft chemical process. The methodologies for trapping or bonding macrocycles inside pristine or organo-modified silica or inside ZrO₂ xerogels were developed by using phthalocyanines and porphyrins as molecular probes. The sizes of the pores formed depend on the structure, the cation nature, and the identities and positions of peripheral substituents of the macrocycle. The interactions of the macrocyclic molecule and surface Si-OH groups inhibit the efficient displaying of the macrocycle properties and to avoid this undesirable event, strategies such as situating the macrocycle far from the pore walls or to exchange the Si-OH species by alkyl or aryl groups have been proposed. Spectroscopic properties are better preserved when long unions are established between the macrocycle and the pore walls, or when oligomeric macrocyclic species are trapped inside each pore. When macrocycles are trapped inside organo-modified silica, their properties result similar to those displayed in solution and their intensities depend on the length of the alkyl chain attached to the matrix. These results support the prospect of tuning up the pore size, surface area, and polarity inside the pore cavities in order to prepare efficient catalytic, optical, sensoring, and medical systems. The most important feature is that research would confirm again that tetrapyrrolic macrocycles can help in the development of the authentic pore engineering in materials science.

Using a fuzzy system in the study of the luminescence and potency of neodymium ions

The processes of energy transfer and diffusion of photons emitted by Nd(3+) ions embedded into a glass sample were investigated. The luminescence resolved in space allowed the observation of the photons' spatial distribution. In this paper, we propose a fuzzy mathematical model that permits carrying out calculations based on the neighborhood luminescence intensity of the excitation spot laser. This proposed model differs from other well-known ones in the literature because it shows clearly the luminescence intensity profile on the sample surface.

Monitoring photosensitizer uptake using two photon fluorescence lifetime imaging microscopy

Photodynamic Therapy (PDT) provides an opportunity for treatment of various invasive tumors by the use of a cancer targeting photosensitizing agent and light of specific wavelengths. However, real-time monitoring of drug localization is desirable because the induction of the phototoxic effect relies on interplay between the dosage of localized drug and light. Fluorescence emission in PDT may be used to monitor the uptake process but fluorescence intensity is subject to variability due to scattering and absorption; the addition of fluorescence lifetime may be beneficial to probe site-specific drug-molecular interactions and cell damage. We investigated the fluorescence lifetime changes of Photofrin(®) at various intracellular components in the Mat-LyLu (MLL) cell line. The fluorescence decays were analyzed using a bi-exponential model, followed by segmentation analysis of lifetime parameters. When Photofrin(®) was localized at the cell membrane, the slow lifetime component was found to be significantly shorter (4.3 ± 0.5 ns) compared to those at other locations (cytoplasm: 7.3 ± 0.3 ns; mitochondria: 7.0 ± 0.2 ns, p < 0.05).

Triple-functional core-shell structured upconversion luminescent nanoparticles covalently grafted with photosensitizer for luminescent, magnetic resonance imaging and photodynamic therapy in vitro

Upconversion luminescent nanoparticles (UCNPs) have been widely used in many biochemical fields, due to their characteristic large anti-Stokes shifts, narrow emission bands, deep tissue penetration and minimal background interference. UCNPs-derived multifunctional materials that integrate the merits of UCNPs and other functional entities have also attracted extensive attention. Here in this paper we present a core-shell structured nanomaterial, namely, NaGdF(4):Yb,Er@CaF(2)@SiO(2)-PS, which is multifunctional in the fields of photodynamic therapy (PDT), magnetic resonance imaging (MRI) and fluorescence/luminescence imaging. The NaGdF(4):Yb,Er@CaF(2) nanophosphors (10 nm in diameter) were prepared via sequential thermolysis, and mesoporous silica was coated as shell layer, in which photosensitizer (PS, hematoporphyrin and silicon phthalocyanine dihydroxide) was covalently grafted. The silica shell improved the dispersibility of hydrophobic PS molecules in aqueous environments, and the covalent linkage stably anchored the PS molecules in the silica shell. Under excitation at 980 nm, the as-fabricated nanomaterial gave luminescence bands at 550 nm and 660 nm. One luminescent peak could be used for fluorescence imaging and the other was suitable for the absorption of PS to generate singlet oxygen for killing cancer cells. The PDT performance was investigated using a singlet oxygen indicator, and was investigated in vitro in HeLa cells using a fluorescent probe. Meanwhile, the nanomaterial displayed low dark cytotoxicity and near-infrared (NIR) image in HeLa cells. Further, benefiting from the paramagnetic Gd(3+) ions in the core, the nanomaterial could be used as a contrast agent for magnetic resonance imaging (MRI). Compared with the clinical commercial contrast agent Gd-DTPA, the as-fabricated nanomaterial showed a comparable longitudinal relaxivities value (r(1)) and similar imaging effect.

Green light emitting diodes accelerate wound healing: characterization of the effect and its molecular basis in vitro and in vivo

Because light-emitting diodes (LEDs) are low-coherent, quasimonochromatic, and nonthermal, they are an alternative for low level laser therapy, and have photobiostimulative effects on tissue repair. However, the molecular mechanism(s) are unclear, and potential effects of blue and/or green LEDs on wound healing are still unknown. Here, we investigated the effects of red (638 nm), blue (456 nm), and green (518 nm) LEDs on wound healing. In an in vivo study, wound sizes in the skin of ob/ob mice were significantly decreased on day 7 following exposure to green LEDs, and complete reepithelialization was accelerated by red and green LEDs compared with the control mice. To better understand the molecular mechanism(s) involved, we investigated the effects of LEDs on human fibroblasts in vitro by measuring mRNA and protein levels of cytokines secreted by fibroblasts during the process of wound healing and on the migration of HaCat keratinocytes. The results suggest that some cytokines are significantly increased by exposure to LEDs, especially leptin, IL-8, and VEGF, but only by green LEDs. The migration of HaCat keratinocytes was significantly promoted by red or green LEDs. In conclusion, we demonstrate that green LEDs promote wound healing by inducing migratory and proliferative mediators, which suggests that not only red LEDs but also green LEDs can be a new powerful therapeutic strategy for wound healing.

The antimicrobial activity of photodynamic therapy against Streptococcus mutans using different photosensitizers

Several photosensitizers have been used against oral bacteria without standardization. Singlet oxygen ((1)O(2)) is an aggressive chemical species that can kill cells through apoptosis or necrosis.

OBJECTIVE

to compare the antimicrobial activity of photodynamic therapy (PDT) with different photosensitizers at the same concentration against Streptococcus mutans. In addition, the (1)O(2) production of each photosensitizer was determined. The photosensitizers (163.5 μM) methylene blue (MB), toluidine blue ortho (TBO) and malachite green (MG) were activated with a light-emitting diode (LED; λ=636 nm), while eosin (EOS), erythrosine (ERI) and rose bengal (RB) were irradiated with a curing light (λ=570 nm). Light sources were operated at 24 J cm(-2). For each photosensitizer, 40 randomized assays (n=10 per condition) were performed under one of the following experimental conditions: no light irradiation or photosensitizer, irradiation only, photosensitizer only or irradiation in the presence of a photosensitizer. After treatment, serial dilutions of S. mutans were seeded onto brain heart infusion agar to determine viability in colony-forming units per milliliter (CFU mL(-1)). Generation of (1)O(2) was analyzed by tryptophan photooxidation, and the decay constant was estimated. Results were analyzed by one-way ANOVA and the Tukey-Kramer test (p<0.05). PDT with irradiation in the presence of the photosensitizers TBO and MG was effective in reducing S. mutans counts by 3 and 1.4 logs, respectively (p<0.01), compared to their respective untreated controls. MB generated 1.3 times more (1)O(2) than TBO, and both produced significantly higher concentrations of singlet oxygen than the other photosensitizers. Since in vitro bulk (1)O(2) production does not indicate that (1)O(2) was generated in the bacterial activity site, the bactericidal action against S. mutans cannot be related to in vitro singlet O(2) generation rate. In vitroS. mutans-experiments demonstrated TBO as the only photosensitizer that effectively reduced 99.9% of these microorganisms.

Optofluidic phantom mimicking optical properties of porcine livers

One strategy for assessing efficacy of a liver transplant is to monitor perfusion and oxygenation after transplantation. An implantable optical sensor is being developed to overcome inadequacies of current monitoring approaches. To facilitate sensor design while minimizing animal use, a polydimethylsiloxane (PDMS)-based liver phantom was developed to mimic the optical properties of porcine liver in the 630-1000 nm wavelength range and the anatomical geometry of liver parenchyma. Using soft lithography to construct microfluidic channels in pigmented elastomer enabled the 2D approximation of hexagonal liver lobules with 15mm sinusoidal channels, which will allow perfusion with blood-mimicking fluids to facilitate the development of the liver perfusion and oxygenation monitoring system.

Production of reactive oxygen species from photosensitizers activated with visible light sources available in dental offices

OBJECTIVES

The aim of this study was to assess the ability of commonly available red- or blue-light dental sources to generate reactive oxygen species (ROS) from photosensitive chemicals that might be useful for photodynamic antimicrobial chemotherapy (PACT).

BACKGROUND

Although the use of red diode lasers is well documented, there is limited information on how useful blue-light sources might be for PACT in dental contexts.

MATERIALS AND METHODS

A diode laser (Periowave; see Table 1 for material and equipment sources) emitting red light (660-675 nm) was used to activate toluidine blue; riboflavin and pheophorbide-a polylysine (pheophorbide-a-PLL) were photoactivated using an Optilux 501 curing unit emitting blue light (380-500 nm). Ozone gas (generated by OzoTop, Tip Top Tips, Rolle, Switzerland), sodium hypochlorite, and hydrogen peroxide were used for comparison. ROS production was estimated using an iodine-triiodide colorimetric assay, and ROS levels were plotted versus concentration of chemicals to determine each chemical's efficiency in ROS production. One-way ANOVA with Tukey post hoc analysis (alpha = 0.05) was used to compare the efficiencies of ROS production for the various chemicals.

RESULTS

Sodium hypochlorite, hydrogen peroxide, and ozone gas produced ROS spontaneously, whereas pheophorbide-a-PLL, riboflavin, and toluidine blue required light exposure. The efficiency of ROS production was higher for pheophorbide-a-PLL and toluidine blue than for ozone gas or riboflavin (p < 0.05). Hydrogen peroxide was the least efficient ROS producer.

CONCLUSIONS

The results of the current study support the use of blue- or red-light-absorbing photosensitizers as candidates to produce ROS for clinical applications. Blue-light photosensitizers were as efficient as red-light photosensitizers in producing ROS and more efficient than the oxidant chemicals currently used for dental disinfection.